Three days earlier, Ronald Gomes had gone through a successful open-heart surgery. He was in recovery when he experienced a life-threatening stroke. A CAT scan revealed that Gomes had a large blood clot near his brain. Without prompt intervention, the stroke would likely leave Gomes severely disabled or dead.
Due to the fact that Gomes was recently recovering from heart surgery, the treatment most often utilized for stroke, tissue plasminogen activator (tPA), a clot-dissolving drug, was not an option. Until recently, tPA was the only treatment approved by the Food and Drug Administration (FDA) for the emergency care of strokes.
Although tPA has shown great promise, it has limitations. It can only be used within the first three hours after having a stroke-a window of time that is often not large enough for patients to get to the hospital. In addition, and an essential fact in Gomes's case, patients who have existing medical conditions who receive tPA are at risk of a fatal hemorrhage.
Due to his recent heart procedure, Gomes could not risk tPA treatment. His only other option, one that has only recently become available, was the Merci Retrieval System*. The Merci Retrieval System is able to literally pull blood clots out of the brain, working much like a corkscrew. It is the first medical device approved by the FDA to physically remove blood clots from the brains of stroke patients. The retriever device can be used on those patients who are ineligible for tPA treatment and has been used successfully on patients up to eight hours after the onset of symptoms, extending the treatment window significantly.
To use the retriever, doctors snake a catheter through an artery to the brain, then use the miniature corkscrew-shape device to pull the clot out and immediately restore blood flow to the brain. In some cases, the Merci Retriever has been so successful that it has immediately reversed paralysis and loss of speech in stroke patients.
Gomes's physicians at The Miriam were concerned. The device was still relatively new and they had yet to use the device without combining it with tPA treatment. Physicians were concerned that they wouldn't be able to pull the entire clot out at once. Aware of the risks, Gomes's wife made the decision that the Merci Retrieval System was the best, and only, option for her husband.
Once the permission was granted,The Miriam Hospital's Douglas DeOrchis, MD, interventional radiologist, went to work. The device was inserted and DeOrchis was able to remove Gomes's clot in one piece, restoring blood flow to his brain immediately. Just six weeks later, Ronald Gomes was 99 percent recovered and feeling great.
The Miriam Hospital is one of only two hospitals in the state that has interventional radiologists specially trained to use the Merci Retrieval Device. For Gomes, their expertise was the difference between life and death.
For more information about the Stroke Center at The Miriam Hospital, please call 401-793-5533.
* The Merci Retrieval System is a registered trademark of Cocentric Medical Inc.